In medical school, all students learn that the most common aphasias come down to four questions:
- Can he or she name (e.g. objects)?
- Repeat? (as in sentences)
- Express? (information, ideas in fluent sentences)
As it turns out, these 4 questions may come in handy for more ordinary classroom situations, too.
Because of the way the brain is organized, it is possible to repeat back information without any comprehension. So if a person has the misfortune of experiencing a stroke in just a particular spot, he or she might struggle to understand speech, but still be able to repeat back like a tape recorder. The auditory information is registered or received, but it's not fully comprehended. This is often easy for family members and clinicians to recognize in the abrupt presentation of a stroke, but more subtle when insidiously going on among students.
The sentence repetition loop serves an important function as a back-up when information can't be comprehended quickly. If you didn't understand something when you first heard it, a good "tape loop function" can replay it for you so you can figure it out the second time around.
Strong tape loop kids are tricky - because they always seem "so smart" (they remember so much of what they have heard) - but the real business of testing understanding can only be ascertained if they can explain it in their own words, or apply the information to another appropriate situation.
For young children, it can be particularly difficult figuring out if they really get something because they may not yet be good at paraphrasing or extrapolating the information to another situation. The important thing for parents and teachers to know is that every variation can happen - children who can have excellent naming, repetition, and comprehension, but weak expression, or excellent repetition, comprehension, and expression, but weak naming, and well...you get the drift. Added to this, many children can become quite clever at hiding the fact that they are using nonverbal (e.g. visual) cues to figure out what a person is saying or what they're supposed to be doing in class, or even higher-order filling ability to "guess" what certain words or word clusters should mean. One bright 12 year-old broke down when she confessed that she didn't know what certain words meant in the questions on tests - and that was why her grades were so erratic...it depended more on how certain questions were worded, than whether she was well-prepared. If you see a discrepancy between test-taking or student- or group-generated work, it might also be a good idea to see whether the nature of the problem is more related to language than knowledge.
Some dyslexic students can be caught in this snare because they may use strong inference abilities to make educated guesses about what is being said. With carefully questioning, though, one may discover surprising lapses in word identifications and meaning.
How Can Parents or Teachers Help?
1. In one-on-one work (reduce embarrassment), ask students to define words using their own words (paraphrase).
2. Don't assumed incorrectly answered essay questions are due to "carelessness" - and go over mistakes on tests. If it looks as if a student answered a question prompt incorrectly, carefully review the problem to see why the question may have been misinterpreted.
3. Concept mastery should never be demonstrated by repetition alone. Knowledge is gained when a student can relate information to something they already know, paraphrase information in their own words, draw analogies to a different relevant situation, or express it in a different form altogether (like a picture or diagram).
One last reminder, too: because there are different routes for word-related information to enter the brain (listening, reading), many students vary in their efficiencies of learning through listening and the printed word (actually this not uncommon among language-based stroke patients, too). At the upper elementary - higher education levels, teachers should aim to present information both in visual and verbal forms. Some students may get most of their information listening alone, others by visual means (printed word, figures), and others only when both are combined.
At right, see how inferring is quite different from knowing (blue, low ambiguity words) what a word means.
Arcuate Fasciculus figure
Inference and fMRI pdf
Speech Comprehension and fMRI pdf
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